That's a lot of injuries

A who's who of NBA players are on the shelf. A team made of Russell Westbrook, Derrick Rose, Kobe Bryant, Steve Nash, Rajon Rondo, Danny Granger, David Lee, Danilo Gallinari, Amare Stoudemire, and Lou Williams would contend. Instead all those players and more are out for all or most of the playoffs.

Asking what caused all those injuries takes you on a bit of wild goose chase. There have always been injuries in all sports; I doubt we'll ever know if these are connected in some way or just a random and unlucky collection of events.

But there is a better question with more of an answer: Are there things we can do to reduce the likelihood of injuries in the future? That's what Working Bodies is all about. And that's where the research is not crystal clear, but has been getting incredibly busy.

Violent moments

Russell Westbrook was injured on a play where Patrick Beverley went all out to help his team win -- even if it was both a long shot to work, and obviously creating one of the highest risk moments of Westbrook's night.

In the aftermath many have talked about Beverley's intent -- as if it's a important to know if he wanted to injure Westbrook or not. I say let's skip that debate. We'll never know his intent, and who cares anyway. Let's talk risk. Risk we know. All by himself Beverley created a moment that in retrospect is costing Westbrook, the Thunder and NBA fans a bunch of performances that were dear to all of them.

If I roll a bowling ball down the corridor of my office building, I may well hurt somebody. I might do it only with the most fun of intentions. But if you manage the building ... who cares? What matters is I don't do it again. What matters is I value my co-workers safety a little more.

The NBA would like Beverley to place a little higher value on Westbrook's safety. Forget what's dirty or not, or unknowable things like who's thinking evil thoughts. What's likely to cause injuries? Let's reduce that. Let's get players thinking, just a little more, about making sure they don't end each other's seasons. That's where plays like Beverley's, as well as blows to the head, and any plays that risk players hitting their heads on the court -- all things we now know are more dangerous than we ever thought -- ought to be the kinds of things the rules and the referees aggressively discourage.

Players going all-out to help their teams win will always have their supporters. It's a macho world. You won't get NBA legends lining up to support the NBA on this kind of change. That's fine. But if you're in David Stern's office, it's a problem that a player could make a dangerous decision like that, reckless enough to possibly end the season of the most resilient player in NBA history, and not even be called for a common foul, let alone a flagrant or an ejection.

These violent high-risk moments could be much more scarce. Many are intentional, which means they're not inevitable or part of the game, and would be easy to stop if people wanted to. Much of the time playing with little care about injuring others helps your team. If you ran the league, wouldn't you have to fix that?

A marathon

There's another lingering question for the league to consider: Are player spending too much time exhausted, and does that put them at excessive risk to get injured?

A little detour into running: If you train to run 400 meters -- that's one lap of the track -- training will include some 100-meter sprints and some mile-or-longer runs. Training works like that, more or less. You attack from all angles. Train for a five kilometer (3.1 mile) race and you can bet you'll do some sprints, as well as some runs are much longer than 3.1 miles.

But then there's the marathon. It's 26.2 miles. And if you train for a marathon, almost no matter what training regimen you use, you'll never be asked to run more than 20 miles.

Pretty weird, huh? You want to do five miles fast as you can, you'll sometimes run ten. You want to do ten miles fast as you can, and training involves regular runs of 12 or 15.

Race 26.2, though, and even at elite levels, chances are race day will take you further than any other day of the year. Almost all the experts agree on this.

And the reasoning is simple: Get a lot of people running 25 miles, and you'll get a lot of people injured. It just happens that way. There's some kind of real limit around 20 miles. Push past that, and maybe some outliers can handle it, but for the broad population it's just courting trouble.

Marathoners have known about this for decades and have long been skipping the monster training runs.

Meanwhile, it's looking like the 82-game NBA regular season might work like one monster training run.

Exhaustion does weird stuff

From a 2010 Brad Stenger article published by the Medill School of Journalism:

Gregory Dupont from the University of Lille's Laboratory of Human Movement Studies in France monitored injuries during the 2007-2008 and 2008-2009 UEFA Champions League seasons. He found the injury rate was six times higher when players played two matches per week versus one match per week. He published the study in the American Journal of Sports Medicine last April.

During the regular season NBA teams play 2-4 games per week and travel longer distances than a typical European soccer team.

Researchers have been putting little heart rate and motion sensors on soccer players in Europe. What they've been finding is something not unlike what marathon training regimens have long known: Get somebody exhausted, and their likelihood of injury skyrockets, even for the kinds of injuries you might think have nothing to do with fatigue.

When you're fresh, your soft tissue has a certain elasticity. Your muscles and tendons can cope with a normal amount of upset, like say, another player bashing into you while you're trying to call a timeout. Also, your own ability to be balanced and coordinated -- now we're talking nervous system stuff -- is good when you're in your comfort zone. On top of all that, when you're training a comfortable amount, it's a cinch to maintain good form.

Get yourself good and worn out, though, and a lot of those systems that keep you safe go away. I started training for marathons a few years ago, and the first time I ran 18 miles, I felt great most of the time, but with about two miles left things changed. I started to feel mighty brittle, like if somebody were to push me ever-so-gently from the side I would simply topple over. Not to mention I was bleary-eyed, imbalanced, with ragged form, and making poor decisions. Where you used to have these living, breathing, expanding, contracting things called muscles it feels like you now have old rope.

It's more than a little scary, in that state, to encounter the tiniest obstacles. A bumpy sidewalk, a twig in the street, a car that doesn't give you much room ... any and all can put you in peril. You have little ability to adjust to life's little challenges.

Research suggests you're an off-the-charts injury risk at that moment. And it feels like it.

In soccer they've been finding that same stuff. Exhausted players evidently lack normal range of motion, balance and coordination. An impact, fall or collision that might not injure a rested person might injure someone who has been going hard every day for months. In soccer, experts working with this theory have, amazingly, predicted injuries before they happen. Basically, they can look at who's running ragged out there, who's deep in the red zone of exhaustion. And then they have often been correct -- even though the injury ends up coming on a fluky-seeming play.

Word is spreading

Increasingly, NBA teams are tuning into the perils of exhaustion. One of those soccer experts who brags about predicting injuries is Italian Jean-Pierre Meerseman, who spoke at the Global Sports Management Summit in May in San Francisco. Many NBA bigwigs were in the audience, and they report he blew their minds with tales of knowing who'd be injured before the injury happened.

One NBA front office guy who tracks the work of Meerseman and others says he's increasingly coming to the view that the best approach for stars is to spend as much time as possible with their feet up. He's thinking the winning approach, given the rigorous schedule, might be to forego everything else, as in every practice all season, as well as every minute of play that wasn't essential.

A company called Apollo MIS, which recently merged with STATS, does some of that European-soccer style exhaustion tracking, and has some NBA clients. One of their most enthusiastic is the Spurs ... the very team which leads the league every year in intentionally sitting stars. A game when the schedule has been harsh on them? Tim Duncan, Manu Ginobili and Tony Parker sit. Ditto for any fourth quarter when the game isn't close. Even as some claim they've found the fountain of youth for Duncan and the like, they've even gotten in trouble with the league for it.

But the way the data is shaping up, it seems likely the league is going to face some tough choices: Change the schedule in a profound way to allow for meaningful rest and real in-season training. Or stare down the barrel of a growing body of evidence suggesting one of the things causing NBA injuries are decisions made by the NBA.